Beauregard L A, Waxman H L, Volosin R, Volosin K J, Kurnik P B
Department of Medicine, Cooper Hospital/University Medical Center, UMDNJ/Robert Wood Johnson Medical School, Camden, USA.
Pacing Clin Electrophysiol. 1996 Jun;19(6):883-9. doi: 10.1111/j.1540-8159.1996.tb03383.x.
Signal averaging has been performed to evaluate late potentials following infarction and the administration of thrombolytic therapy. Most studies have recorded signal-averaged electrocardiograms (SAECGs) at least 12 hours after the onset of the infarction. In this study, SAECGs were recorded before thrombolytic therapy and serially over 7-10 days following infarction in 21 patients. The high frequency QRS duration was significantly shortened at 1 and 24 hours compared to presentation (96.8 +/- 11.3 ms and 93.4 +/- 8.0 ms vs 103.3 +/- 14.3 ms, respectively, P < 0.05) and there was an increase in the terminal voltage over time, significant at 1 hour and 3 days (57.3 +/- 29.1 microV and 58.6 +/- 44.7 microV vs 44.4 +/- 35.5 microV, respectively, P < 0.01). Five patients met criteria for ventricular late potentials on at least one SAECG. The prevalence of late potentials was higher in patients with Q wave infarctions, or with occluded infarct related arteries. These changes in myocardial activation may be related to ischemia and reperfusion, and may not correlate with the development of a fixed substrate for reentry.
已进行信号平均以评估心肌梗死后及溶栓治疗后的延迟电位。大多数研究在心肌梗死发作至少12小时后记录信号平均心电图（SAECG）。在本研究中，对21例患者在溶栓治疗前及心肌梗死后7至10天连续记录SAECG。与就诊时相比，高频QRS时限在1小时和24小时时显著缩短（分别为96.8±11.3毫秒和93.4±8.0毫秒，而就诊时为103.3±14.3毫秒，P<0.05），且终末电压随时间增加，在1小时和3天时具有显著性（分别为57.3±29.1微伏和58.6±44.7微伏，而就诊时为44.4±35.5微伏，P<0.01）。5例患者至少在一份SAECG上符合心室延迟电位标准。Q波心肌梗死患者或梗死相关动脉闭塞患者延迟电位的发生率较高。心肌激活的这些变化可能与缺血和再灌注有关，且可能与折返的固定基质的形成无关。
